Some selected abstract:

Malavige GN, Ranatunga PK, Velathanthiri VG, Fernando S, Karunatilaka DH, Aaskov J, Seneviratne SL.  Patterns of disease in Sri Lankan dengue patients. Arch Dis Child. 2006 May;91(5):396-400.

Department of Microbiology, Faculty of Medical Sciences, University of Sri Jayawardenapura, Sri Lanka.

BACKGROUND: Dengue is the most important mosquito borne viral infection in the world. Nearly 90% of infections occur in children. At present, prospective information on clinical and laboratory findings in South Asian children with dengue is generally lacking. AIM: To describe patterns of clinical disease in a cohort of children hospitalised with dengue during a major dengue epidemic in Sri Lanka. RESULTS: A total of 104 children were studied during a three month period. Eighteen had dengue fever (DF) and 86 had dengue haemorrhagic fever (DHF). Of those with DHF, 34, 23, 27, and 2 had DHF grade I, II, III, and IV respectively. Based on dengue serology testing, 13 of the DF patients had a primary infection and 5 had secondary dengue infections. In contrast, 68 of the children with DHF had secondary and 18 had primary dengue infections. Oral candidiasis was seen in 19 children. The odds ratio for children with secondary dengue infection to develop DHF was 9.8 (95% CI 3.1 to 31.2). CONCLUSION: Studies on patterns of paediatric dengue disease in different regions should help clinicians and health administrators make more informed and evidence based health planning decisions. It should also help towards mapping out dengue trends on a global scale. Oral candidiasis has not been previously documented in children suffering with acute dengue in Sri Lanka or elsewhere. Studying underlying reasons for this manifestation during future dengue epidemics may provide useful leads in understanding overall dengue pathogenesis.

Rigau-Perez JG.  Severe dengue: the need for new case definitions. Lancet Infect Dis. 2006 May;6(5):297-302. Review.

Dengue Branch, Division of Vector-Borne Infectious Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, San Juan, PR, USA. jgrigau@prdigital.com

Dengue fever imposes a societal burden that is difficult to measure because of the disease's non-specific symptoms and the lack of easily applied case definitions for its more severe manifestations. An efficacy trial of a tetravalent vaccine is expected in the near future, but only one of the severe dengue syndromes-the continuum of dengue haemorrhagic fever and dengue shock syndrome-is well defined. One of the results of the focus on dengue haemorrhagic fever is the false perception of low disease burden in the Americas, which is an obstacle to the mobilisation of political and economic resources to fight the disease. Three improvements are necessary to standardise the dengue haemorrhagic fever definition and to allow it to do well in different populations: (1) redefine the threshold for thrombocytopenia, (2) clarify the standard practice and value of the tourniquet test, and (3) incorporate a criterion to measure intravenous fluid replacement. In addition, for an accurate estimation of dengue burden, locally appropriate definitions of severe dengue must be devised and standardised so they will be considered valid in the global research community.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

14696.  Balasubramanian S, Janakiraman L, Kumar SS, Muralinath S, Shivbalan S. A reappraisal of the criteria to diagnose plasma leakage in dengue hemorrhagic       fever. Indian Pediatr. 2006 Apr;43(4):334-9.

14697.  Gomes-Ruiz AC, Nascimento RT, de Paula SO, Lopes da Fonseca BA.  SYBR green and TaqMan real-time PCR assays are equivalent for the diagnosis of dengue virus type 3 infections. J Med Virol. 2006 Jun;78(6):760-3.

14698.  Grobusch MP, Niedrig M, Gobels K, Klipstein-Grobusch K, Teichmann D.  Evaluation of the use of RT-PCR for the early diagnosis of dengue fever. Clin Microbiol Infect. 2006 Apr;12(4):395-7.

Therapy:

14699.  Finsterer J, Kongchan K.  Severe, persisting, steroid-responsive Dengue myositis. J Clin Virol. 2006 Apr;35(4):426-8.

14700.  Khor BS, Liu JW, Lee IK, Yang KD.  Dengue hemorrhagic fever patients with acute abdomen: clinical experience of 14 cases. Am J Trop Med Hyg. 2006 May;74(5):901-4.

14701.  Mendes Wda S, Branco Mdos R, Medeiros MN. Clinical case report: Dengue hemorrhagic fever in a patient with acquired immunodeficiency syndrome. Am J Trop Med Hyg. 2006 May;74(5):905-7.

14702.  Nguyen TH, Nguyen TL, Lei HY, Lin YS, Le BL, Huang KJ, Lin CF, Do QH, Vu TQ, Lam TM, Yeh TM, Huang JH, Liu CC, Halstead SB. Volume replacement in infants with dengue hemorrhagic fever/dengue shock syndrome. Am J Trop Med Hyg. 2006 Apr;74(4):684-91.